Hip and knee replacement patients not receiving treatment to reduce blood clot risk
Standard medication not being offered to elderly, at-risk population, say MUHC researchers
Hip and knee replacement surgery patients - who are often elderly - are at increased risk of developing potentially life-threatening thrombosis, or blood clots. Nevertheless, according to a study by Dr. Elham Rahme of the Research Institute of the Ï㽶ÊÓƵ Health Centre (RI-MUHC) and McGill University, most patients in Quebec do not receive the recommended treatment to prevent a thrombosis. The study will be published June 3 in the Canadian Medical Association Journal.
Dr. Rahme and her team analyzed the records of 7,058 Quebec hip and knee replacement patients, and discovered that only 19 percent of them received post-discharge antithrombotic treatment. The percentage varied somewhat between different hospitals and different lengths of hospital stay, but in almost all cases it remained well below official guidelines, which recommend at least 10 days, and up to 35 days, of treatment after surgery.
Although mortality risk following hip and knee replacement surgery is low, it increases for patients who do not receive antithrombotic treatment after leaving the hospital, the researchers said.
"This study is only the first step in a vast project on thrombosis related to hip and knee replacements. We have now determined the number of antithrombotic drug prescriptions in Quebec; our next step will consist in recruiting patients to analyze how well their prescribed antithrombotic treatments correspond to their medical conditions," Dr. Rahme explained.
It's unknown why antithrombotic drugs are so consistently underused, but concern about potential side-effects, particularly in the elderly, is one possibility. Nevertheless, the researchers said, this could not fully explain the huge gap between official treatment guidelines and the clinical realities revealed by this study.
Dr Rahme is a researcher in the "Health Outcomes" axis of the Research Institute of the MUHC. She is also an Associate Professor at Ï㽶ÊÓƵ's Faculty of Medicine and an Associate member of McGill's Department of Epidemiology and Biostatistics.
This study was supported by the Canadian Institutes of Health Research (CIHR).
The Ï㽶ÊÓƵ Health Centre (MUHC) is a comprehensive academic health institution with an international reputation for excellence in clinical programs, research and teaching. Its partner hospitals are the Montreal Children's Hospital, the Montreal General Hospital, the Royal Victoria Hospital, the Montreal Neurological Hospital, the Montreal Chest Institute and the Lachine Hospital. The goal of the MUHC is to provide patient care based on the most advanced knowledge in the health care field and to contribute to the development of new knowledge.
The Research Institute of the Ï㽶ÊÓƵ Health Centre (RI MUHC) is a world-renowned biomedical and health-care hospital research centre. Located in Montreal, Quebec, the institute is the research arm of the MUHC, the university health center affiliated with the Faculty of Medicine at McGill University. The institute supports over 600 researchers, nearly 1200 graduate and post-doctoral students and operates more than 300 laboratories devoted to a broad spectrum of fundamental and clinical research. The Research Institute operates at the forefront of knowledge, innovation and technology and is inextricably linked to the clinical programs of the MUHC, ensuring that patients benefit directly from the latest research-based knowledge. The Research Institute of the MUHC is supported in part by the Fonds de la recherche en santé du Québec. For further details visit:
